HomeMy WebLinkAboutWells for Eugene Pc 1
Summary Statement of Contributions and Expenditures Re,, -
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C~an4idage~or P~ilical~ittee Name (use full name):
Mailing Addicts as it AppeatO on Statement of Organization (street, route or l~x number city, state, zip code)'
Treasurer s Name: ~O Telephone Number (day):
Committee ID Number. Committee Type, Measure Number or Office:
[~] Original [] Pr,mary 20~ [] General 20~ [] Other £ ..
[] Amendment [] 1st Pre-elecnon [] 2nd Pre-election [] Post-election { [] 20_fi September Supplemental
A-TOTALS FOR THIS ~"~ '~ ~-CUMULATIVE TOTALS
ACCOUNTING PERIOD FOR THIS ELECTION
CONTRIBUTIONS
1. Cash Contributions
(Accounting Period Total from PC 2)
2. Loans Received (Non-Exempt) + +
(Accounting Permd Total from PC 2)
3. Total Cash Contributions
(hnes 1+ 2)
4. in-Kind + +
(Accounting Period Total from PC 2)
5. TOTAL CONTRIBUTIONS
(hnes 3 + 4)
EXPfiNDITUR~$
6. Cash Expenditures
(Accounung Period Total from PC 3)
7. Loan Payments (Non-Exempt) + +
(Accounting Period Total from PC 3
8. Total Cash Expenditures =
(lines 6 + 7)
9. In-Kand + + _
(Accounting Period Total from PC 2)
10. TOTAL EXPENDITURES = \~q. 5~~ =
(hnes 8 + 9)
CASH BALANCE
11. Begirming Cash Balance
OFFICE
FOR
USE
ONLY-
12. Total Contribunons +
(hne 5)
13. Other Receipts +
~.Accountmg Period Total from PC 4A}
14. Loans Received (Exempt) +
(Accounting Period Total from PC 4A)
15. CONTRIBUTION SUBTOTAL
(hnes 11 + 12' 13 + i4)
16. ,otalExpendltures ~'4. ~& RECEIVED
(hne 10)
17. Other Disbursements +
(Accounting Period Total from PC 4B)
18. Loan Payments (Exempt) +
(AccoantmgPenodTotalffomPC 4B) ,CiTY
19. EXPENDITURE SUBTOTAL
(lines 16 + 17 + 18)
20. ENDING CASH BALANCE =
(hne 15 rmnus line 19)
PC 1
Summary Stmement of Contributions and Expenditures .-
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Candidate or Political Commmee Name: Committee ID Number:
[] Original [] Primary 20~ [] General 20~ [] Other
[] Amendment [] 1st Pre-elect~on [] 2nd Pre-election [] Post-elect~on [] 20 September Supplemental
LOAN
21 Begmmng Outstanding Loans FOR OFFICE USE ONLY
(hne 29 of previous report)
22. Loans Received (Non-Exempt) +
(hne 2)
23. Loans Received (Exempt) +
(line 141
24. LOANS RECEIVED SUBTOTAL
(lines 21 * 22 + 23) :
25. Loan Payments (Non-Exempt)
(hne 7)
26. Loan Payments (Exempt) +
(line 18)
27. Forgiven Loans
(Total lomas forgwen during th~s accounting period)
28. LOAN PAYMENT SUBTOTAL
(lines 25 + 26 +27) =
29. TOTAL OUTSTANDING LOANS
(hne 24 m~nus hne 28) =
PERSONAL EXPENDITURE SUMI~IARY
30. Beginning Outstanding Personal Expenditures
(hne 36 ofprewous report)
31. Personal Expen&tures +
(Accounting Period Total from PC 3Al
32. PERSONAL EXPENDITURE SUBTOTAL
(hnes 30 + 31)
33. Personal Expenditure Reimbursements
(Total expen&mres on PC 3 w~th pm'pob¢ code R)
34. Forgiven Personal Expenditures +
(.Total personal expen&mres forgiven th~s acctg period)
35. REIMBURSEMENT SUBTOTAL
(hnes 33 -~ 34)
36. OUTSTANDING PERSONAL
EXPENDITURES =
FINANCIAL STATUS AT CLOSE OF ACCOUNTING PERIOD
37. Ending Cash Balance
(lme 20/
38. Accounts Recmvable
+
(Accounting Period Total from PC 5)
39. SUBTOTAL
(hnes 37 + 38)
40~ Total Outstanding Loans
(hne 29)
41. Outstanding Personal Expenditures +
{hne 36l
42. Accounts Payable +
(Accounnng Period Total from PC 6)
43. SUBTOTAL
(hnes 40 + 41 + 42 )
44. BALANCE/DEFICIT ~/}
(hne 39 minus hne 43 re&cate + or - balance)
L .C~k/, ~._ '~J,~?~,~ (name of candidate or treasurer), hereby certify that the above
statement and the attached supporting reports are true and correct.
Signature of can&da'ie or treasurer Date signed
PC
Cash Contributions, Loans Received and In-Kind
Candidate or Political Committee Name: Committee ID Number:
Page of
Elecnon: [] Primary 20 [~1 General 20 [~ Other
Report: [] 1st Pre-election [] 2nd Pre-elecnon [] Post-elect~on [] 20 September Supplemental
SEE BACK FOR INSTRUCTIONS AND CODE DEFINITIONS
CODE l: Contributor Type CODE 2: Contribution Type
B Business Ennty CA Cash
C Polmcal Cormmttee (includes bus~ness and union PACs) CO Cosigner Obhganon
F Can&date's Immediate Family 0ncludes candidate) IK In-Kind
I Individual LR Loan Re~ived
L Labor Organization
O Other
P Political Party Committee
Amount of //f~ in-Kind Purpose
Line # Name and Address of Contr¢butor Contribution./ ~o~e manual for suggested purpose codes)
Occupational Information or Contributor/
Date Received Contnbutin~t Committee's ID# Aggregaje~ Code '/ Code 2
/
/~$
/
/
2. ~/ $
/
/
/
$
$
$
See Page Totals (Add all amounts with the same Accounting Period Totals (Complete only for last page and
Instructions contnbunon type. Do not include aggregates.) transfer these amounts to the Summary Statement, PC 1 .)
on Back and
~n Campmgn Cash (CA) $ Cash (CA)
Enter on Surmnary Statement, Colmrm
Finance
Manual In-Kind (IKt $ In-Kind (IK) $
Enter on Summary. Statement, Column A, Lines 4 and 9
PC 2 Loans Received (LR) $ Loans Received (LR) $
Enter on Stmamary Statemem, Cotump. A~ Line 2
PC
Cash Expenditures and Loan Payments Rev
Candidate or Po~cal Committee Name: Committee ID Nm-nber:
Election [] Primary 20 [] General 20 [] Other
Report. [] 1st Pre-election [] 2nd Pre-elect~on [] Post-elecnon [] 20 September Supplemental
PURPOSE CODES tsee back of form for instructions and code definitions) EXPENDITURE TYPES
A Agent O Od~er Advertising (yard signs, buttons, etc.} CA Cash
B Broadcast Advertising (Radio, TV) P Postage LP Loan Payment
C Cash Contnbunons R ReLmbursement for Personal Expenditures
F Fundraising Event Expenses S Surveys and Polls
G General Operational Expenses (describe ~fover $50) T Travel Expenses (describe ~fover $50}
I Interest Payment U Uttht~es
L Literature, Brochures, Printing W Wages, Salaries, Benefits
M Management Services Y Petition C~rculators
N Newspaper and Other Periodicai Advertiang Z PreparaUon and Production of Advemsing
Payee's Name and Payee's Committee ID~,
Exp. Amount of
Line # Date Check # ff applicable Purpose Type Expendmre PaN
(as it appears on invoice, receipt or check) to AlP
3 $
9. * [~
10. $ ~
Sec Page Totals (Add all expenditures w~th the same Accounting Period Totals (Complete only for last page and
lnstructmns expenditure type.) transfer these amounts to the Summary Statement, PC 1.)
on Back and
in Campaign Cash (CA) $ ~(, ~- Cash (CA) $ I~4 ~ ~ ~
Finance E, me~ on Summary Statement. Cokann A. Line 6
Manual Loan Payment t LP) $ Loan Payment (LP) $
Enter on Summary Staternenr~ Colt~rnn A, Line 7
PC 3